DOMINIC EDWARD FULLENKAMP MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036141808

License Status

ACTIVE

Business

Title

First Name

DOMINIC

Middle

EDWARD

Last Name

FULLENKAMP

Business Name

DOMINIC EDWARD FULLENKAMP MD

Original Issue Date

10/04/2016

Effective Date

04/25/2023

Expiration Date

07/31/2026

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

04/25/2023